"No major scientific or medical organizations, including the American Cancer Society (ACS), American Urological Association (AUA), US Preventive Services Task Force (USPSTF), American College of Physicians (ACP), National Cancer Institute (NCI), American Academy of Family Physicians (AAFP), and American College of Preventive Medicine (ACPM) support routine testing for prostate cancer at this time."

This is a quote taken from an update (July 30, 2009) on the American Cancer Society website titled "Can Prostate Cancer Be Found Early?"

this is the link:http://www.cancer.org/docroot/cri/content/cri_2_4_3x_can_prostate_cancer_be_found_early_36.asp

I just found it this morning while doing a little research about testing. I have read it 3 times and the ramifications of this either elude me or scare the hell out me for others that will follow the path that we are all on.

I sure would welcome some other views and opinions on this. It sure seems to speak volumes to me about the lack of support for PCa awareness and the call for testing.

Such comments have been disceted several times in other topic-specific discussions, I'm recalling. What certain "organizations" advocate, or don't, hasn't been of particular interest to me. I think the medical practicioners don't follow in lock-step with the organizations and that they're doing a lot of testing with men - and that's how my primary care physician handled my situation by testing me starting at 50 years-old and becoming more suspicious when I was 58 and the PSA test results started to change. Rather than rely on others we men (and women) need to take control of our own health care and raise the questions, have the discussions, continue to probe . . . with those who care for our health needs.

Age: 60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's: 3+3, Tertiary 4

Margins: Free

Bladder & Urethral: Free

Seminal vesicles: Not involved

Lymphatic/Vascular Invasion: Not involved

Tumor: T2c; Location: Bilateral; Volume: 20%

Catheter: Removed 12-days after surgery

Incontinent: Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

You a make a good point. I think it is a really strong point that needs to get out that "WE" as individuals, have to take a much stronger role in our health and well being.

It just seems to me that it makes it a little more difficult when organizations like this say they do not support the testing and establishment of baselines.

When most guys find us here at HW they are already diagnosed and at a point when some sort of action needs to be taken. Finding out things a little earlier because of pro-active involvement seems to open a whole other set of alternatives.

I think ALL of us on this board, as well as all PCa boards are passionately opposed to any organization that claims psa testing is a waste of time. For me, if I didn't get tested in late 2005, by now I would be feeling the affects of metastasis and looking at maybe 2-3 years of remaining life. There is nothing more shocking to find out TOO LATE that you have cancer, when a cheap test like the psa test, done yearly, would and HAS saved a ton of men from an early demise. Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined (T2B)

All I can figure is that the organizations against routine testing feel that the tests may lead to unnecessary treatment. I understand that some PCa is slow-growing and may not ever get to the point of being life-threatening, but there is clearly some PCa that is very aggressive and needs to be treated promptly. I would like to know more, and make my own decisions, than know less and count on the percentages to break my way.

Living in the northern Atlanta suburbs.

Good health and no symptoms when my annual physical uncovered an elevated PSA.

Actually, when I read the entire page it seemed very well reasoned to me.

The advice quoted is against testing all men regardless of age. The recommendation isFor men of average risk, offer screening at age 50For African-American men and those with a close family member with PC offer screening at age 45For men with more than one family member with PC, offer screening at 40In each case, if the man asks the doctor to make the decision, screening should start.

This is talking about routine annual screening. I did not see that it addressed baseline screening, something which we strongly advise for all of our sons.Age at diagnosis 66, PSA 5.5Biopsy 12/08 12 cores, 8 positiveGleason 3+4=7CAT scan, Bone scan 1/09 both negative.

At the PCRI event this past weekend, nobody was in agreement with Otis Brawley and the ACS. We generally viewed his constant interviewing on TV to be a counter productive poison.

Here are some facts:The AUA does call for anual testing generally. But they do when there are risk factors involved. The AUA recently released a new call for PSA baseline tests at the age of 40 for all men and 35 for those with high risk factors.USPSTF ~ This wonderful group is responsible for the recommendation about a year and a half ago that doctors stop testing men over 75. This caused quite a stir that the advocacy groups looked into the panel ~ There were no urologists, no prostate cancer oncologists, two lawyers, and a large group of folks making recomendations for Medicare. For me they can say whatever they want, I just won't expect to hear what I think I should.

NCI and ACP ~ They pretty much are inline with the AUA.

AAFP and APCM ~ Who? None of us need our family practisionors after a diagnosis of prostat cancer anyway....Or Otis Brawley...

Again another poorly researched article...

Tony

Age 47 (44 when Dx)

Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007

My new radiation oncologist made an interesting observation on her nearing 30 years experience. She said it sure seems like the most agressive cancers seem to be with the younger men and women. With PCa, she said the worse cases she had worked with are men in their 40s and early 50s, and thats why PCa should be treated early and agressively in that age range. Most of the indolent cases she had worked with were men in their mid 60s to 70s. She said she had experienced the same thing with breast cancer in women, with the worse cases being with women in their 20s and 30s.

Purgatory said...My new radiation oncologist made an interesting observation on her nearing 30 years experience. She said it sure seems like the most agressive cancers seem to be with the younger men and women. With PCa, she said the worse cases she had worked with are men in their 40s and early 50s, and thats why PCa should be treated early and agressively in that age range. Most of the indolent cases she had worked with were men in their mid 60s to 70s. She said she had experienced the same thing with breast cancer in women, with the worse cases being with women in their 20s and 30s.

David in SC

David,

The reason for that is cells divide more rapidly in younger people. Its like when you break a bone: at 20 years old it may take 6 weeks to mend. At 70 years old it may take 12 weeks to mend. Rapid abnormal cell division will result in more aggressive cancers. Age -57; Diagnosed 10/05 PSA 13.4 GS 9 Organ confined (T2B)

Joey, that very well may have a bearing on it. But on the other hand, when you are young, you sometimes aren't as prone to illness and disease (obvious exceptions of course). 2 of the 3 radiation oncologists I have met with feel that cancers are almost 100% genetically generated, basicially at conception in your DNA, which would include those people who have cancers run in their families. I still feel that the exposures in my life in my 20s to really carcenigenic fluids and materials would have had to had an effect on why it seems like Ive become a cancer magnet over the years.

Four years ago, in preparation for my 52 year physical (My first since turning 50) my doc submitted a blood work requisition for me. If he had checked off the PSA box in addition to the usual cholesterol, sugar etc., I might be writing this reply while wearing big boy pants instead of diapers and making hay tonight with my wife rather than Augie. Instead, he followed some lugnut's recommendation and skipped it. I didn't know any better. At age 56 I had my first routine PSA test for life insurance. It was 17+! Thank you Metropolitan Life for saving me - even though you b*stards won't give me insurance.

One more thing on this ~ the American Cancer Society has over 100 prostate cancer handouts that conflict with the advice of their medical director...Just thought I'd mention that. Has anyone noticed that Dr. Brawley and I would not get along well? I would have to take a number to do that anyway. At the PCRI event last weekend, ACS had a booth with tons of prostate cancer brochures. Almost all the documents said that the only proactive defense in prostate cancer was screening.

Tony Age 47 (44 when Dx)

Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007

I just read in the newspaper today that University Associates of Rochester are offering free prostate cancers screening at their office during September. I don't know what this entails but you can check it out by going to their website uarochester.com

This might be a good opportunity for someone who has a doc that is reluctant to order a PSA. Jeff (Full disclosure statement: I have no business interest in UAR)